The central Asian republics (‏CAR)‏ are engaged in a process of health care reform. To support the CAR in this process, the WHO Regional Office for Europe established CARNET (‏the Central Asian Republics' Network for Health Care Reforms)‏ in 1993. The CAR are also developing national environmental health action plans (‏NEHAPs)‏. The sanitary epidemiological services (‏SES)‏ play a leading role in environmental health in the CAR. The SES in the CAR have established vertical structures. This has led to gaps between the SES and health care activities and ...